This study aimed to evaluate the feasibility and reproducibility of using cardiovascular magnetic resonance feature tracking (CMR-FT) for analysis of bi-ventricular strain and strain rate (SR) in hypertrophic cardiomyopathy (HCM) patients as well as to explore the correlation between right ventricular (RV) and left ventricular (LV) deformation.
A total of 60 HCM patients and 48 controls were studied. Global and segmental peak values of bi-ventricular longitudinal, circumferential, radial strain, and systolic SR were analyzed. Pearson analysis was performed to investigate the correlation of RV and LV deformation. Intra-observer and inter-observer reproducibility were also assessed.
LV mass in the HCM group was significantly higher than that in the control group. LV end-systolic and end-diastolic volume and RV end-systolic and end-diastolic volume in the HCM group were all significantly lower than the correlated parameters in the control group (p < 0.001, respectively), whereas no statistical difference was found in ejection fraction (p > 0.05). Global longitudinal strain (GLS), global longitudinal strain rate (GLSR), global circumferential strain (GCS), global circumferential strain rate (GCSR), global radial strain (GRS), and global radial strain rate (GRSR) of the LV and RV were all significantly lower than the control group, and segmental strain and SR were also true (p < 0.001, respectively). Bi-ventricular strain and SR measurements were highly reproducible at both intra- and inter-observer levels. Additionally, Pearson analysis showed RV GCS, GLS, and GRS positively correlated with LV GCS, GLS, and GRS (r = 0.713, p < 0.001; r = 0.728, p < 0.001; r = 0.730, p < 0.001, respectively).
CMR-FT is a promising approach to analyze impairment of global and segmental myocardium deformation in HCM patients non-invasively and quantitatively.
• CMR-FT allows for advanced myocardial characterization with high reproducibility.
• As compared with controls, HCM patients have significant differences in CMR-FT strain analysis while ejection fraction was similar.
• CMR-FT may serve as an early biomarker of HCM in subjects at risk.
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Cardiovascular magnetic resonance feature tracking
Global circumferential strain
Global circumferential strain rate
Global longitudinal strain
Global longitudinal strain rate
Global radial strain
Global radial strain rate
Preserved ejection fraction
Standard steady-state free precession
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The authors would like to specially thank Professor Lingzhi Hu, M.D. (from united imaging healthcare), for his expert advices for the design of our experiments and the image analyses. In addition, we thank Assistant Professor YingFeng Tu, Ph.D. (Cardiology Department of the 2nd Harbin Medical University Affiliated Hospital, Harbin, China), and QunShao, Ph.D. (Cardiology Department of the 3rd Harbin Medical University Affiliated Hospital, Harbin, China), for their assistance with the preparation of this manuscript.
This study has received funding by the National Natural Science Foundation of China General Projects (81571740) (KW), Scientific Research Grant of Heilongjiang Province Natural Science Foundation for Returned Chinese Scholars (LC201436) (KW), Postdoctoral Special Scientific Research Grant of Heilongjiang Provincial Government (LBH-Q17104) (KW), Distinguished Young Scientist Funding of Harbin Medical University Affiliated Tumor Hospital (JCQN2019-02), Key Project of the Climbing Funding of the National Cancer Center (NCC201808B019), Youth Scientific Research Grant of Heilongjiang Province Natural Science Foundation (QC2015127) (LZ), Medical Scientific Research Foundation of Heilongjiang Province Health Department (2014-312) (LZ), and Natural Science Foundation of 2nd Affiliated Hospital Harbin Medical University (KTBS2015-26) (LZ). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
The scientific guarantor of this publication is Kezheng Wang.
Conflict of interest
The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.
Statistics and biometry
No complex statistical methods were necessary for this paper.
Written informed consent was obtained from all subjects (patients) in this study.
Institutional Review Board approval was obtained.
• Multicenter study
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Liping Yang and Lingbo Zhang contributed equally to this work.
Electronic supplementary material
(DOCX 719 kb)
LV circumferential strain is displayed in 4D volume. The movie shows a representative case of LV tracking in the short-axis view in HCM patient. (AVI 5501 kb)
LV radial strain is displayed in 4D volume. The movie shows a representative case of LV tracking in the short-axis view in HCM patient. (AVI 5497 kb)
LV longitudinal strain is displayed in 4D volume. The movie shows a representative case of LV tracking in the long-axis four-ventricular view in HCM patient. (AVI 5728 kb)
RV circumferential strain is displayed in 4D volume. The movie shows a representative case of RV tracking in the short-axis view in HCM patient. (AVI 6447 kb)
RV longitudinal strain is displayed in 4D volume. The movie shows a representative case of RV tracking in the long-axis four-ventricular view in HCM patient. (AVI 5718 kb)
RV radial strain is displayed in 4D volume. The movie shows a representative case of RV tracking in the short-axis view in HCM patient. (AVI 6031 kb)
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Yang, L., Zhang, L., Cao, S. et al. Advanced myocardial characterization in hypertrophic cardiomyopathy: feasibility of CMR-based feature tracking strain analysis in a case-control study. Eur Radiol (2020). https://doi.org/10.1007/s00330-020-06922-6
- Cardiovascular magnetic resonance
- Feature tracking
- Hypertrophic cardiomyopathy